This is a revised renewal application for a multidisciplinary program of postdoctoral research training with a focus on the comorbidity of psychiatric and medical disorders and the delivery of mental health care in general medical and long term care settings. It is administered through the Section on Geriatric Psychiatry at the University of Pennsylvania with participation of faculty from Psychiatry, Medicine, Family Practice, and Epidemiology/Biostatistics, and from the Research Department of the Philadelphia Geriatric Center. The goals of the program are to prepare M.D. and Ph.D. trainees to function as independent investigators and/or as investigators able to develop an independent line of investigation in the context of larger scale, multicenter studies. It will consider applicants with M.D. and Ph.D. degrees who are committed to careers in intervention research. The fellowship will admit 2-4 fellows/year for 2-3 years of training with a focus on mentorship and supervised research experiences complemented by formal coursework, workshops, and tutorials. All fellows will participate in the University's Patient Oriented Research Training core, and training in the ethical conduct of research. M.D.'s without prior formal research training will participate in the MS program in Clinical Epidemiology (MSCE). For others, participation in the MSCE program will be elective; however, at least one formal course per semester will be required. For each fellow, the experience will be guided by an individualized training plan, developed by the trainee and his/her mentor and approved by the steering committee. Progress will be monitored both within the program and by an external consultant/advisor. The training opportunities within this program span the breadth of intervention research ranging from randomized clinical trials/efficacy studies, through effectiveness studies to practice and services research. The program arises from a faculty that is actively involved in research on mental health and mental disorders in primary and specialty medical care settings, and on the mental disorders of the elderly, a group in which psychiatric-medical comorbidity is the rule. The support sought through this program will make an array of resources available for trainees including Penn's NIMH-supported Intervention Research Center on Psychiatric-Medical Comorbidity, other enabling resources, and an extensive portfolio of research grants.